Sinonasal Malignancies of Anterior Skull Base

Castelnuovo, Paolo; Turri‐Zanoni, Mario; Battaglia, Paolo; Antognoni, Paolo; Bossi, Paolo; Locatelli, Davide

doi:10.1016/j.otc.2015.09.012

Cited by 109 publications

(62 citation statements)

References 51 publications

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“…Our study analyzed a population of 417 patients affected by sinonasal malignancies treated with surgery in association with radio and/or chemotherapy depending on staging and histotype. 2 We report an overall rate of recurrence of 28%, lower than most of the series available in the literature: this can be explained by the exclusion of patients who did not achieve a successful treatment, as this group would have invalidated the analysis of recurrences. The first recurrence was local, regional, and distant in 68.4%, 6%, and 25,6% of cases, respectively.…”

Section: Rate Of Recurrence and Risk Factorsmentioning

confidence: 58%

The role of a post therapeutic surveillance program for sinonasal malignancies: Analysis of 417 patients

et al. 2019

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Background: Post therapeutic surveillance of head and neck neoplasms is a still debated issue in the current literature: although different works tried to establish frequency, modality, and efficacy of a routine follow-up, little evidence has been produced, in particular considering only sinonasal malignancies.Methods: A retrospective review of patients treated for sinonasal malignancies in a single tertiary center and followed through a regular program of follow-up was carried out. Rate of recurrence, location, timing, diagnosis, and salvage treatment were the main data analyzed. Results: Of note, 417 patients were included in the study and 117 experienced at least one relapse. Staging, histological type, and previous treatment represent the main clinical factors to be considered to stratify patient's risk of recurrence. Conclusion:A regular post therapeutic surveillance can provide an early recurrence detection for patients treated for sinonasal malignancies, offering opportunity for salvage treatment in a high percentage of patients. K E Y W O R D S endoscopic sinus surgery, oncology, sinonasal malignancies, skull base, surveillance

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Section: Rate Of Recurrence and Risk Factorsmentioning

confidence: 58%

The role of a post therapeutic surveillance program for sinonasal malignancies: Analysis of 417 patients

et al. 2019

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“…6 Current treatment approaches to sinonasal tumors include craniofacial resection, endoscopic surgery, and radiation therapy (RT) (including intensity-modulated RT [IMRT] techniques). [12][13][14][15][16][17][18][19] However, survival benefits with all the above-mentioned approaches remain poor; therefore, for the management of sinonasal cancers the sequencing and combinations of multimodal treatments have been gaining importance and relevance. 18,19 In this regard, the incorporation of induction chemotherapy (IC) into the treatment strategy with the aim to reduce distant metastasis and possibly impact on locoregional control has shown promising results despite having been obtained from heterogeneous series and within small studies.…”

Section: Introductionmentioning

confidence: 99%

Locally advanced epithelial sinonasal tumors: The impact of multimodal approach

et al. 2019

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Objective Outcomes of locally advanced epithelial sinonasal cancers remain unsatisfactory; moreover, only limited and heterogeneous data exist on prognostic factors. Methods We reviewed all consecutive patients with American Joint Committee Cancer stage III to IV epithelial sinonasal cancers treated with platinum‐based induction chemotherapy (IC) followed by locoregional treatment between 1996 and 2015. Results We identified 69 patients treated with a multimodal approach (IC, surgery, radiotherapy). Overall, 44 patients recurred (64%). Of those, 19 patients received salvage surgery, but only four remained disease‐free. Median overall survival (OS) was 62.5 months. Sinonasal neuroendocrine and small cell histotypes (P = 0.0085), neuroendocrine differentiation (P = 0.006), and lack of response to IC (P = 0.03) were associated with worse OS. In patients who recurred, median OS was 13 months since recurrence. Survival was longer in patients submitted to salvage surgery (44%) than in those receiving chemotherapy alone at recurrence (29.5 vs. 4.6 months). Patients with a clinical benefit after palliative chemotherapy had a longer median OS than those with disease progression (29.2 vs. 4.4 months; P < 0.0001). Conclusion Globally, the prognosis of locally advanced epithelial sinonasal cancers is dismal, with worse outcomes for neuroendocrine lesions. In the recurrent setting, feasibility of salvage surgery and clinical benefit from palliative chemotherapy are associated with longer OS. A multimodal treatment strategy with IC seems to offer improved OS when compared with other retrospective series not employing such a therapeutic tool. Level of Evidence 4 Laryngoscope, 130:857–865, 2020

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“…In all cases, the surgical margins were examined intraoperatively with frozen sections, and the resection was enlarged until clear margins were obtained or if further resections were impossible to achieve regardless of the approach. The indications, contraindications, and specific surgical techniques of the different approaches have been detailed previously …”

Section: Methodsmentioning

confidence: 99%

“…The indications, contraindications, and specific surgical techniques of the different approaches have been detailed previously. [13][14][15] Postoperative treatments included adjuvant radiotherapy (RT) in cases of close or positive surgical margins; perineural invasion or involvement of critical regions such as frontal sinus, sphenoid sinus, lamina papyracea or periorbit; pterygopalatine fossa; and anterior skull base (with or without dural infiltration). The postoperative RT was delivered using the three-dimensional conformal RT or intensity modulated RT (IMRT) or particle RT.…”

Section: Surgerymentioning

confidence: 99%

Endoscopic endonasal resection of adenoid cystic carcinoma of the sinonasal tract and skull base

et al. 2018

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Objectives Adenoid cystic carcinoma (ACC) is a locally aggressive salivary gland malignancy prone to perineural invasion and local recurrences. In the literature, few data exist to guide treatment when this tumor involves the paranasal sinuses and skull base. We report our experience in the management of sinonasal adenoid cystic carcinoma through an endoscopic endonasal approach. Methods Retrospective analysis of patients affected by sinonasal ACC treated through an endoscopic endonasal approach from 1997 to 2015, managed at the Universities of Varese and Brescia, Italy. Results Thirty‐four patients were included in the analysis. The ethmoid sinus (55.9%), nasal septum (17.7%), maxillary sinus (11.7%), and sphenoid sinus (5.9%) were the primary tumor sites encountered. Twenty patients (58.8%) presented with T3 or T4, without any systemic spreading. Twenty‐nine patients underwent endoscopic transnasal resection, whereas the involvement of the anterior skull base in five cases required a transnasal endoscopic craniectomy. Overall, 20 of 34 (58.8%) patients received some form of adjuvant radiotherapy. The follow‐up ranged from 12 to 202 months (mean of 73.2 months). The 5‐year overall, disease‐specific, and recurrence‐free survival rates were 86.5% ± 7.39%, 86.5% ± 7.39%, and 71.8% ± 8.67%, respectively. Conclusions The endoscopic approach is safe and effective for selected sinonasal ACC, reducing the comorbidities of the external approaches while producing similar oncological results. High T‐stage, grade III histology, positive surgical margins, and perineural infiltration all have an important negative prognostic value. Level of Evidence 4 Laryngoscope, 129:1071–1077, 2019

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Sinonasal Malignancies of Anterior Skull Base

Cited by 109 publications

References 51 publications

The role of a post therapeutic surveillance program for sinonasal malignancies: Analysis of 417 patients

The role of a post therapeutic surveillance program for sinonasal malignancies: Analysis of 417 patients

Locally advanced epithelial sinonasal tumors: The impact of multimodal approach

Endoscopic endonasal resection of adenoid cystic carcinoma of the sinonasal tract and skull base

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